Abstract
BackgroundManganese (Mn) is an essential element for humans, but exposure to high levels has been associated with adverse developmental outcomes. Early epidemiological studies evaluating the effect of Mn on fetal growth are inconsistent.MethodsWe investigated the association between maternal urinary Mn during pregnancy and the risk of low birth weight (LBW). Mn concentrations in maternal urine samples collected before delivery were measured in 816 subjects (204 LBW cases and 612 matched controls) recruited between 2012 and 2014 in Hubei Province, China.ResultsThe median Mn concentration in maternal urine was 0.69 μg/g creatinine. Compared to the medium tertile of Mn levels, an increased risk of LBW was observed for the lowest tertile (≤0.30 μg/g creatinine) [adjusted odds ratio (OR) = 1.28; 95 % confidence interval (CI) = 0.67, 2.45], and a significantly increased risk of LBW was observed for the highest tertile (≥1.16 μg/g creatinine) [adjusted OR = 2.04; 95 % CI = 1.12, 3.72]. A curvilinear relationship between maternal urinary Mn and risk of LBW was observed, showing that the concentration at 0.43 μg/g creatinine was the point of inflection. Similar associations were observed among the mothers with female infants and among the younger mothers < 28 years old. However, among the mothers with male infants or the older mothers ≥ 28 years old, only higher levels of Mn were positively associated with LBW.ConclusionsLower or higher levels of maternal urinary Mn are associated with LBW, though only the association of LBW risk and higher levels of Mn was statistically significant. The findings also show that the associations may vary by maternal age and infant sex, but require confirmation in other populations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2816-4) contains supplementary material, which is available to authorized users.
Highlights
Manganese (Mn) is an essential element for humans, but exposure to high levels has been associated with adverse developmental outcomes
Elevated urinary concentrations have been reported to correlate to elevated concentrations of Mn in drinking water in pregnant women living in Bangladeshi, Table 3 Risk of low birth weight associated with maternal urinary manganese levels, stratified by maternal age
The results showed that the Mn concentrations in maternal urine observed in this study were comparable to those seen in pregnant women in western Australia [33] and California, USA (0.40 μg/L) [34]
Summary
Manganese (Mn) is an essential element for humans, but exposure to high levels has been associated with adverse developmental outcomes. The general population is exposed to Mn through consumption of food and water, Xia et al BMC Public Health (2016) 16:142 inhalation of air, and contact with consumer products that contain Mn. The general population is exposed to Mn through consumption of food and water, Xia et al BMC Public Health (2016) 16:142 inhalation of air, and contact with consumer products that contain Mn Human activities such as mining, metal smelting, and other industrial uses of Mn may increase Mn levels in the environment [5]. An increasing number of studies suggest that excess exposure to Mn may have detrimental effects on the developing organism, neurological development [6, 7]. Maternal exposure to high levels of Mn through drinking water in Bangladesh has been related to increased fetal abnormalities and fetal mortality [8]
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